Corticospinal tract structure and excitability in patients with anterior cruciate ligament reconstruction: A DTI and TMS study.

Autor:	Lepley AS; School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, United States; Brain Imaging Research Center, University of Connecticut, Storrs, CT, United States. Electronic address: alepley@umich.edu., Ly MT; Brain Imaging Research Center, University of Connecticut, Storrs, CT, United States; Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States., Grooms DR; Ohio Musculoskeletal and Neurological Institute & Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, United States., Kinsella-Shaw JM; Department of Kinesiology, University of Connecticut, Storrs, CT, United States., Lepley LK; School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, United States.
Jazyk:	angličtina
Zdroj:	NeuroImage. Clinical [Neuroimage Clin] 2020; Vol. 25, pp. 102157. Date of Electronic Publication: 2019 Dec 27.
DOI:	10.1016/j.nicl.2019.102157
Abstrakt:	Background: Underlying neural factors contribute to poor outcomes following anterior cruciate ligament reconstruction (ACLR). Neurophysiological adaptations have been identified in corticospinal tract excitability, however limited evidence exists on neurostructural changes that may influence motor recovery in ACLR patients. Objective: To 1) quantify hemispheric differences in structural properties of the corticospinal tract in patients with a history of ACLR, and 2) assess the relationship between excitability and corticospinal tract structure. Methods: Ten participants with ACLR (age: 22.6 ± 1.9 yrs; height: 166.3 ± 7.5 cm; mass: 65.4 ± 12.6 kg, months from surgery: 70.0 ± 23.6) volunteered for this cross-sectional study. Corticospinal tract structure (volume; fractional anisotropy [FA]; axial diffusivity [AD]; radial diffusivity [RD]; mean diffusivity [MD]) was assessed using diffusion tensor imaging, and excitability was assessed using transcranial magnetic stimulation (motor evoked potentials normalized to maximal muscle response [MEP]) for each hemisphere. Hemispheric differences were evaluated using paired samples t-tests. Correlational analyses were conducted on structural and excitability outcomes. Results: The hemisphere of the ACLR injured limb (i.e. hemisphere contralateral to the ACLR injured limb) demonstrated lower volume, lower FA, higher MD, and smaller MEPs compared to the hemisphere of the non-injured limb, indicating disrupted white matter structure and a reduction in excitability of the corticospinal tract. Greater corticospinal tract excitability was associated with larger corticospinal tract volume. Conclusions: ACLR patients demonstrated asymmetry in structural properties of the corticospinal tract that may influence the recovery of motor function following surgical reconstruction. More research is warranted to establish the influence of neurostructural measures on patient outcomes and response to treatment in ACLR populations. Competing Interests: Declaration of Competing Interest The Authors declare that there is no conflict of interest. (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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